LOW-DOSE GLUCOCORTICOIDS AFTER IN-VITRO FERTILIZATION AND EMBRYO-TRANSFER HAVE NO SIGNIFICANT EFFECT ON PREGNANCY RATE

Objective: To determine the effect on pregnancy rate (PR) of low-dose glucocorticoid treatment in cycles without micromanipulation. Design: Randomized, prospective, double-blinded, placebo-controlled trial. Set ting: One university-based tertiary infertility center and two private infertility centers. Patients: All patients receiving standard stimul ation IVF-ET or transfer of cryopreserved embryos at the participating facilities from January to September 1993 were asked to participate i n this study. Patients having micromanipulation were excluded from thi s study. Interventions: Participating patients were randomized to eith er 16 mg oral 6-alpha-methylprednisolone for four evenings starting th e evening of retrieval or the evening before thawing cryopreserved emb ryos or to placebo administered in an identical fashion. Both groups w ere treated with 250 mg oral tetracycline four times per day starting with initiation of the study medication and continuing for 4 days. Cry opreservation and stimulation cycles were managed according to pre-est ablished protocols for all patients. A clinical pregnancy was confirme d by an appropriately rising hCG titer and a gestational sac on ultras ound. Results: A total of 206 stimulation patients and 61 cryopreserva tion patients were randomized and had an ET. Patient characteristics w ere similar between groups. The clinical pregnancy and implantation ra tes between placebo and glucocorticoid groups were 35.9% versus 40.8% and 12.8% versus 11.7% for stimulation cycles and 30.3% versus 25% and 9.9% versus 7.4% for cryopreservation cycles, respectively. None of t hese differences were statistically significant. Conclusions: Glucocor ticoid plus antibiotic treatment at these doses for transfers of nonmi cromanipulated embryos does not appear to have a significant effect on pregnancy or implantation rates.